OBJECTIVE:To investigate the effects of hyperbaric oxygen combined with flupentixol and melitracen on depres-sion improvement,extremity motor function and ability of daily living and activity in patients with post-stroke depression (PSD). METHODS:60 PSD patients were divided into control group and observation group according to random number table,with 30 cases in each group. Both groups received routine clinical treatment,comprehensive rehabilitation therapy and psychotherapy. The control group was additionally given Flupentixol and melitracen tablets,orally,one tablet each time,in the morning;3 days later, one tablet each time,in the morning and noon,for 4 weeks. Other anti-depressive agents were not given during treatment. Observa-tion group was additionally given hyperbaric oxygen,0.12 MPa,for 90 min,qd,5 times a week,for 4 weeks,on the basis of control group. Depression degree [Hamilton depression scale (HAMD) and Self-rating depression scale(SDS)],extremity motor function [Fugl-Mayer motor function assessment (FMA)] and ability of daily living and activity [modified Barthel index (MBI)] were scored in 2 groups before and after treatment,and ADR was observed. RESULTS:After 4 weeks of treatment,HAMD and SDS of 2 groups were decreased significantly compared to before treatment,while FMA and MBI were increased significantly;the improvement of observation group was significantly better than that of control group,with statistical significance(P<0.05). No ob-vious ADR was found in 2 groups. CONCLUSIONS:Hyperbaric oxygen combined with flupentixol and melitracen can effectively improve PSD,relieve negative emotion and improve extremity motor function and ability of daily living and activity.

Objective:To observe the functional differences in the key brain areas in patients with different levels of consciousness after severe brain injury, and provide reference for confirming the objective diagnosis indicators for prolonged disorders of consciousness.Methods:Thirty right handedness patients with different levels of consciousness after severe brain injury (initial post-traumatic Glasgow coma scale scores<9), admitted to our hospital from January 2016 to December 2020, were chosen in our study. The levels of consciousness of these patients were assessed by revised Coma Recovery Scale (CRS-R); according to the diagnostic criteria of prolonged disorders of consciousness, 8 patients were into group of unresponsive wakefulness syndrome/vegetative state (UWS/VS), 8 patients were into group of micro-conscious state (MCS), 6 patients were into group of emergence from MCS (eMCS), and 8 were into group of locked-in syndrome (LIS). The regional homogeneity (ReHo) was used to analyze resting-state functional MRI (rs-fMRI) data to explore the differences of brain functional activity in patients with different levels of consciousness.Results:Strong resting-state activities were noted in the right middle temporal gyrus of the UWS/VS patients, the left culmen and inferior parietal lobule of the MCS patients, the left superior occipital gyrus and inferior frontal gyrus of eMCS patients, and the left inferior temporal gyrus and cingulate gyrus of the LIS patients. As compared with that in the UWS/VS patients, the ReHo value of the left insula in the MCS patients was significantly enhanced (voxel=1 341, t=-5.380, P<0.05); as compared with the those in the eMCS patients, the peak brain area with reduced ReHo value in the MCS patients was the left culmen (voxel=549, t=-5.377, P<0.05), while the peak brain area with enhanced ReHo value was the left insula (voxel=438, t=3.751, P<0.05); as compared with that in the LIS patients, the peak brain areas of enhanced ReHo in the MCS patients were the left medial frontal gyrus (voxel=1 014, t=5.406, P< 0.05) and left extra-nuclear (voxel=229, t=4.115, P<0.05), while the peak brain areas of enhanced ReHo in the eMCS patients was the left medial frontal gyrus (voxel=421, t=3.397, P<0.05). Conclusion:In the resting state, there are functional differences in the key brain regions of patients with different levels of consciousness, mainly in the predominant hemisphere, left insula and cerebellum; these regions may be the target regions for objective evaluation of prolonged disorders of consciousness.

Objective:To evaluate the clinical efficacy of intermittent theta burst stimulation (iTBS) of the bilateral cerebellum in treating post-stroke dysphagia.Methods:Forty patients with dysphagia after a cerebral infarction were randomly divided into a control group and an iTBS group, with 20 cases in each group. In addition to routine swallowing rehabilitation training and nutritional guidance, the iTBS group underwent daily bilateral cerebellar iTBS 6 times a week for 3 weeks, while the control group was given sham stimulation. Before and after the treatment, both groups were evaluated by using the water-swallowing test and the standardized swallowing assessment (SSA), and the latency and amplitude of the mylohyoid muscle′s motor evoked potential (MEP) were also recorded. The SSA scores and MEP amplitudes of the mylohyoid muscle after treatment were tested for any correlation.Results:The treatment improved the water-swallowing test results in both groups, with that of the iTBS group significantly better than that of the control group. The clinical efficacy in the iTBS group was 95%, significantly higher than the control group′s 80%. The SSA scores decreased significantly in both groups after the treatment, with the iTBS group′s average score then significantly lower than that of the control group. The average latency and amplitude of the mylohyoid muscle′s MEP was also significantly better in the iTBS group after the treatment. In the control group only the average amplitude was significantly greater than before the treatment. Pearson correlation analysis showed that the SSA scores and the MEP amplitudes of the mylohyoid muscle after treatment were uncorrelated in both groups.Conclusions:Bilateral intermittent theta burst stimulation can effectively improve the swallowing of patients with post-stroke dysphagia.